Christmas Eye – not as fun as its name

Image by Caleb Woods on Unsplash

Type the words ‘Christmas Eye’ into your Pinterest search bar, and you’ll usually get a series of harmlessly surreal, lol-worthy make-up tutorials. But when Australian optometrists discuss the term, the tone changes dramatically. For them, ‘Christmas Eye’ describes a painful condition that affects the cornea – the eye’s clear, protective outer layer.

The condition is most commonly found around Christmas-time (hence the name) in the south-west region of New South Wales and north east Victoria. It’s ‘monocular', meaning it occurs in one eye (not both) and, as mentioned, it’s painful. Extremely, excruciatingly painful.

“The pain associated with Christmas Eye has achieved folkloric status,” says optometrist Robert Holloway, owner of Holloway Vision in Wangaratta, Victoria. “Sufferers describe it as ‘torturous’ and ‘on par with giving birth’.”

Holloway sees an influx of patients each summer suffering from Christmas Eye. Improving the treatment and management of this painful condition evolves each year and this benefits his regional patients involved in outdoor activities during the dry summer months in south east Australia.

Although first identified in the 1970s, Christmas eye has for a long time remained poorly understood. Generally, sufferers will present at the optometrist or emergency room in the early hours of the morning, with a swollen eye and extreme eye pain that continues to build despite their best efforts to fight it.

For years, the search for the cause of the condition was a mystery, frustrated by a lack of physical evidence. But gradually ongoing research has revealed the culprit: Orthoperus, a small native beetle that releases a painful chemical when crushed on the eye or skin. The chemical, known as Pederin, causes itching, burning lesions on the cornea.

Orthoperus

It’s a terrible condition, especially when it affects children, who often can’t articulate the severity of the pain they are experiencing. The management of Christmas Eye is quite straight-forward once the diagnosis has been made. From there, the optometrist will use an eye-drop anaesthesia to ease the pain, then fit the patient with a bandage contact lens. ‘The pain levels drop as the corneal epithelium recovers,’ Holloway explains.

Christmas Eye is not contagious and it is not commonly seen outside of south-west New South Wales and north east Victoria. The vast majority of patients with Christmas Eye heal perfectly without any ongoing adverse effects. They return to normal, pre-incident visual ability and there are no left-over signs of the corneal ulcer.

“Understandably, Christmas Eye can be stressful for the sufferer,” says Holloway, “so care, reassurance and pain control are the keys in managing this unusual condition.”

If you’re experiencing pain or discomfort in your eye, visit your optometrist as soon as possible. Find an optometrist near you here.

Geographic distribution

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